CN108186166A - Rumpbone fixing bracket - Google Patents
Rumpbone fixing bracket Download PDFInfo
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- CN108186166A CN108186166A CN201711435923.XA CN201711435923A CN108186166A CN 108186166 A CN108186166 A CN 108186166A CN 201711435923 A CN201711435923 A CN 201711435923A CN 108186166 A CN108186166 A CN 108186166A
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- rod
- support rod
- displacement member
- plate
- fixing plate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30749—Fixation appliances for connecting prostheses to the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
- A61F2002/30909—Nets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
- A61F2002/30995—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for sacro-iliac joints
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
本发明提供了一种骶骨固定支架,包含固定板(1)、支撑杆(2)以及补片(4);多个支撑杆(2)中包含第一支撑杆(21)与第二支撑杆(22),第一支撑杆(21)与第二支撑杆(22)在轴向延伸方向上相互平行或存在夹角;补片(4)设置在第一支撑杆(21)与第二支撑杆(22)之间;支撑杆(2)包含杆头部(201)、杆身部(202)、杆尾部(203);杆头部(201)、杆身部(202)、杆尾部(203)依次相连;固定板(1)与所述杆头部(201)相连;第一支撑杆(21)的杆尾部(203)与第二支撑杆(22)的杆尾部(203)相连。本发明固定板上设置有截断槽,根据使用需求调整固定板在髂骨上的固定位置,再将固定板多余的部分截断,以适应不同骶骨截断长度的手术。
The invention provides a sacral fixation bracket, comprising a fixing plate (1), a support rod (2) and a patch (4); a plurality of support rods (2) include a first support rod (21) and a second support rod (22), the first support rod (21) and the second support rod (22) are parallel to each other or have an included angle in the direction of axial extension; the patch (4) is arranged on the first support rod (21) and the second support rod Between the rods (22); the support rod (2) comprises a rod head (201), a shaft part (202), and a rod tail (203); a rod head (201), a shaft part (202), a rod tail ( 203) are connected in turn; the fixed plate (1) is connected with the rod head (201); the rod tail (203) of the first support rod (21) is connected with the rod tail (203) of the second support rod (22). The fixing plate of the present invention is provided with a truncation groove, and the fixed position of the fixing plate on the ilium is adjusted according to the usage requirements, and then the redundant part of the fixing plate is cut off, so as to adapt to operations with different sacral truncation lengths.
Description
技术领域technical field
本发明涉及医疗器械领域,具体地,涉及一种骶骨固定支架。The invention relates to the field of medical devices, in particular to a sacral fixation bracket.
背景技术Background technique
原发脊柱肿瘤中约1%~7%发生在骶骨。据文献报道,肿瘤扩大切除是降低复发率的最佳治疗方式,而实现肿瘤扩大切除往往需要部分甚至全骶骨切除。由于骶骨附近解剖位置复杂,骶骨肿瘤扩大切除术伴随很多并发症,包括大量失血、伤口感染、神经功能损伤与骨盆结构破坏等。About 1% to 7% of primary spinal tumors occur in the sacrum. According to literature reports, extended tumor resection is the best treatment to reduce the recurrence rate, and partial or even total sacral resection is often required to achieve extended tumor resection. Due to the complex anatomical location near the sacrum, extended resection of sacral tumors is accompanied by many complications, including massive blood loss, wound infection, nerve function damage, and pelvic structure destruction.
众所周知,大小便功能的维持要求肛提肌具有正常的解剖形态与功能,盆底发挥正常支撑作用也需要盆底肌的完整性作为前提。然而,在骶骨切除术中,盆底肌肉将不可避免地失去附着点。这将造成盆底肌肉失去正常解剖结构,导致其不能正常收缩以发挥生理功能,从而导致术后大小便失禁、盆腔内容物疝出等各种并发症,严重影响了病人的生活质量。As we all know, the maintenance of defecation function requires the normal anatomical shape and function of the levator ani muscle, and the integrity of the pelvic floor muscle is also a prerequisite for the normal support of the pelvic floor. However, during a sacrectomy, the pelvic floor muscles will inevitably lose their attachment. This will cause the pelvic floor muscles to lose their normal anatomical structure, resulting in their inability to contract normally to perform their physiological functions, resulting in various complications such as postoperative incontinence, herniation of pelvic contents, etc., seriously affecting the quality of life of patients.
目前为止,多种骶骨切除术后软组织重建策略被报道,但尚未出现一种重建术式能充分还原肛提肌的正常解剖结构。因此,为了能够恢复肛提肌的解剖形态,该专利试图重建肛提肌止点。这对骶骨切除术后保留大小便功能、预防盆底疝的发生具有重要意义。So far, a variety of soft tissue reconstruction strategies after sacral resection have been reported, but there is no reconstruction method that can fully restore the normal anatomical structure of the levator ani muscle. Therefore, in order to restore the anatomical shape of the levator ani muscle, this patent attempts to reconstruct the insertion point of the levator ani muscle. This is of great significance for preserving bowel and bladder function and preventing the occurrence of pelvic floor hernia after sacrectomy.
专利文献CN106037993A提供了一种骶骨修复体,包括修复主体,修复主体包括两个第一修复体以及连接在两个第一修复体之间的第二修复体,各第一修复体的第一端与第二修复体连接,两个第一修复体和第二修复体为一体成型结构,各第一修复体的第二端沿远离第二修复体的方向延伸并与髂骨接触配合,第二修复体的顶部与腰椎椎体接触配合;钉棒结构,钉棒结构包连接座以及棒体,连接座与修复主体连接,棒体固定在连接座上。据该专利文献自述能够有效地解决现有技术中的钉棒系统支撑不可靠,容易疲劳断裂的问题。但是该专利文献提供的结构无法有效适应不同患者的不同骶骨髂骨尺寸,手术中骶骨的切除长度也不是固定的,骶骨修复体自身的规格与安装的位置也难以实现灵活调整。Patent document CN106037993A provides a sacral prosthesis, including a prosthetic body, the prosthetic body includes two first prostheses and a second prosthesis connected between the two first prostheses, the first end of each first prosthesis Connected with the second prosthesis, the two first prosthesis and the second prosthesis are integrally formed, the second end of each first prosthesis extends in a direction away from the second prosthesis and contacts with the ilium, and the second prosthesis The top of the prosthesis is in contact with the lumbar vertebral body; the nail-rod structure includes a connection seat and a rod body, the connection seat is connected to the restoration main body, and the rod body is fixed on the connection seat. According to this patent document, it can effectively solve the problems of unreliable support and easy fatigue fracture of the nail-rod system in the prior art. However, the structure provided by this patent document cannot effectively adapt to different sacrum and ilium sizes of different patients, and the length of sacrum resection during surgery is not fixed, and the specification and installation position of the sacral prosthesis itself are difficult to achieve flexible adjustment.
发明内容Contents of the invention
针对现有技术中的缺陷,本发明的目的是提供一种骶骨固定支架。Aiming at the defects in the prior art, the object of the present invention is to provide a sacral fixation bracket.
根据本发明提供的骶骨固定支架,包含固定板、支撑杆以及补片;The sacral fixation bracket provided according to the present invention includes a fixation plate, a support rod and a patch;
多个支撑杆中包含第一支撑杆与第二支撑杆,第一支撑杆与第二支撑杆在轴向延伸方向上相互平行或存在夹角;The plurality of support rods include a first support rod and a second support rod, and the first support rod and the second support rod are parallel to each other or have an included angle in the direction of axial extension;
补片设置在第一支撑杆与第二支撑杆之间;The patch is disposed between the first support rod and the second support rod;
支撑杆包含杆头部、杆身部、杆尾部;杆头部、杆身部、杆尾部依次相连;The support rod includes a rod head, a shaft part and a rod tail; the rod head, the shaft part and the rod tail are connected in sequence;
固定板与所述杆头部相连;第一支撑杆的杆尾部与第二支撑杆的杆尾部相连。The fixing plate is connected with the rod head; the rod tail of the first support rod is connected with the rod tail of the second support rod.
优选地,还包含配接板;配接板由柔性材料制成,Preferably, an adapter plate is also included; the adapter plate is made of a flexible material,
配接板沿长度延伸方向的两端分别与第一支撑杆的杆尾部、第二支撑杆的杆尾部相连;The two ends of the adapter plate along the extending direction of the length are respectively connected with the rod tail of the first support rod and the rod tail of the second support rod;
第一支撑杆、配接板、第二支撑杆依次平滑过渡连接。The first support rod, the adapter plate, and the second support rod are sequentially connected in a smooth transition.
优选地,支撑杆和/或配接板上设置有穿线孔;穿线孔的孔口平滑延伸;Preferably, the support rod and/or the adapter plate are provided with threading holes; the openings of the threading holes extend smoothly;
支撑杆在长度延伸方向上存在弯曲。The support rod is bent in the direction of length extension.
优选地,穿线孔上穿设有调长缝线,调长缝线与补片相连;Preferably, a length-adjusting suture is threaded on the threading hole, and the length-adjusting suture is connected to the patch;
支撑杆和/或配接板表面为粗糙表面;The surface of the support rod and/or the adapter plate is a rough surface;
补片上设置有覆膜,所述覆膜为去细胞的真皮基质生物膜。A membrane is provided on the patch, and the membrane is a decellularized dermal matrix biofilm.
优选地,固定板上设置有钉孔与截断槽;Preferably, the fixing plate is provided with nail holes and cut-off grooves;
钉孔沿固定板厚度方向贯穿固定板,截断槽沿固定板宽度方向延伸;The nail hole runs through the fixed plate along the thickness direction of the fixed plate, and the cut-off groove extends along the width direction of the fixed plate;
钉孔与截断槽在固定板长度延伸方向上依次布置;The nail holes and cut-off grooves are arranged sequentially along the length extension direction of the fixing plate;
所述固定板由柔性材料制成,固定板在长度延伸方向与宽度延伸方向上能够变形。The fixing plate is made of flexible material, and the fixing plate can be deformed in the extending direction of the length and the extending direction of the width.
优选地,所述钉孔为花瓣形,花瓣形的钉孔包含多个瓣体,多个所述瓣体沿钉孔周向方向布置;Preferably, the nail hole is petal-shaped, and the petal-shaped nail hole includes a plurality of petals, and the plurality of petals are arranged along the circumferential direction of the nail hole;
还包含钛网,钛网安装在固定板沿厚度方向一端的端面上;It also includes a titanium mesh, which is installed on the end face of one end of the fixed plate along the thickness direction;
固定板上还贯穿设置有注射孔。Injection holes are also provided through the fixing plate.
优选地,所述固定板包含多个板节,相邻两个板节通过万向调节杆连接;Preferably, the fixed plate includes a plurality of plate sections, and two adjacent plate sections are connected by universal adjustment rods;
板节上设置有钉孔。Nail holes are arranged on the board section.
优选地,杆头部、杆身部或杆尾部上设置有伸缩杆。Preferably, a telescoping rod is provided on the rod head, the shaft or the tail.
优选地,所述伸缩杆包含位移件、翻转块以及翻转弹性绳;Preferably, the telescopic rod includes a displacement member, a turning block and a turning elastic rope;
多个位移件中包含第一位移件与第二位移件,第一位移件与第二位移件中心对称布置;第一位移件与第二位移件相对的两面为台阶面;The plurality of displacement elements includes a first displacement element and a second displacement element, and the first displacement element and the second displacement element are arranged symmetrically to the center; the opposite sides of the first displacement element and the second displacement element are stepped surfaces;
翻转块横截面形状为长方形;多个翻转块设置在第一位移件与第二位移件之间,多个所述翻转块之间通过翻转弹性绳连接;The cross-sectional shape of the overturning block is rectangular; a plurality of overturning blocks are arranged between the first displacement member and the second displacement member, and the plurality of overturning blocks are connected by an overturning elastic rope;
第一位移件与第二位移件之间设置有弹性件,弹性件处于拉伸状态。An elastic piece is arranged between the first displacement piece and the second displacement piece, and the elastic piece is in a stretched state.
优选地,还包含套筒,套筒套接在伸缩杆上;伸缩杆全部位于套筒内部;套筒的侧壁面为光滑面;Preferably, a sleeve is also included, and the sleeve is sleeved on the telescopic rod; all the telescopic rods are located inside the sleeve; the side wall of the sleeve is a smooth surface;
所述弹性件包含拉合弹性绳,拉合弹性绳贯穿翻转块设置;或者,拉合弹性绳被翻转块分隔成两段;The elastic member includes a pulling elastic rope, and the pulling elastic rope is arranged through the turning block; or, the pulling elastic rope is divided into two sections by the turning block;
台阶形的位移件沿长度方向的两端分别形成厚侧端与薄侧端,厚侧端的端面形成拉引面;The two ends of the step-shaped displacement member along the length direction form a thick side end and a thin side end respectively, and the end surface of the thick side end forms a pulling surface;
沿多个位移件排列方向最外侧的位移件上设置有拉引绳;A pulling rope is arranged on the outermost displacement member along the arrangement direction of the plurality of displacement members;
位于同一侧的拉引面与拉引绳均与支撑杆的同一端相连;The pulling surface and the pulling rope on the same side are connected to the same end of the support rod;
第一位移件与第二位移件上还设置有通孔,紧固件穿过所述通孔将第一位移件与第二位移件紧固连接。The first displacement member and the second displacement member are also provided with through holes, and the fastener passes through the through holes to securely connect the first displacement member and the second displacement member.
与现有技术相比,本发明具有如下的有益效果:Compared with the prior art, the present invention has the following beneficial effects:
1、本发明固定板上设置有截断槽,能够根据使用需求调整固定板在髂骨上的固定位置,再将固定板多余的部分截断,以适应不同骶骨截断长度的手术。1. The fixing plate of the present invention is provided with a truncation groove, which can adjust the fixing position of the fixing plate on the ilium according to the needs of use, and then cut off the redundant part of the fixing plate to adapt to operations with different sacral truncation lengths.
2、柔性固定板能够根据髂骨的表面形状进行自适应接触,在固定板与髂骨之间设置钛网等结构,便于更好地使固定板与髂骨进行贴合。2. The flexible fixation plate can make self-adaptive contact according to the surface shape of the ilium, and titanium mesh and other structures are arranged between the fixation plate and the ilium, so as to better fit the fixation plate and the ilium.
3、本发明中设置有穿线孔,用于对补片形状大小进行调节,使得补片4能够更好地起到托住盆腔器官的作用,防止术后病人因为咳嗽等剧烈活动导致盆腔器官疝出。3. Threading holes are provided in the present invention to adjust the shape and size of the patch, so that the patch 4 can better support the pelvic organs and prevent postoperative patients from causing pelvic organ hernia due to severe activities such as coughing. out.
4、支撑杆与配接板上的粗糙表面能够方便肌肉组织的爬升长入,提高本发明的固定能力,同时,补片上覆膜的设置,能够有效起到防粘连的作用。4. The rough surface of the support rod and the adapter plate can facilitate the climbing and growing of muscle tissue, and improve the fixing ability of the present invention. At the same time, the setting of the covering film on the patch can effectively play the role of anti-adhesion.
5、通过伸缩杆的设置,进一步增强了本发明对手术位置的适应能力。5. Through the setting of the telescopic rod, the adaptability of the present invention to the operation position is further enhanced.
附图说明Description of drawings
通过阅读参照以下附图对非限制性实施例所作的详细描述,本发明的其它特征、目的和优点将会变得更明显:Other characteristics, objects and advantages of the present invention will become more apparent by reading the detailed description of non-limiting embodiments made with reference to the following drawings:
图1为本发明结构示意图;Fig. 1 is a structural representation of the present invention;
图2为固定板A向示意图;Figure 2 is a schematic diagram of the fixed plate A;
图3为变化例中固定板结构示意图;Fig. 3 is the structural representation of fixed plate in the variation example;
图4为本发明带伸缩杆的示意图;Fig. 4 is the schematic diagram of band telescoping rod of the present invention;
图5为伸缩杆未拉伸结构示意图;Fig. 5 is a schematic diagram of the unstretched structure of the telescopic rod;
图6为伸缩杆部分拉伸结构示意图;Fig. 6 is a schematic diagram of the partial stretching structure of the telescopic rod;
图7为伸缩杆完全拉伸时结构示意图;Fig. 7 is a schematic diagram of the structure when the telescopic rod is fully stretched;
图8为花瓣形钉孔的一种样式的结构示意图;Fig. 8 is a structural schematic diagram of a pattern of petal-shaped nail holes;
图9为花瓣形钉孔的另一种样式的结构示意图。Fig. 9 is a structural schematic diagram of another pattern of petal-shaped nail holes.
图中示出:The figure shows:
具体实施方式Detailed ways
下面结合具体实施例对本发明进行详细说明。以下实施例将有助于本领域的技术人员进一步理解本发明,但不以任何形式限制本发明。应当指出的是,对本领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干变形和改进。这些都属于本发明的保护范围。The present invention will be described in detail below in conjunction with specific embodiments. The following examples will help those skilled in the art to further understand the present invention, but do not limit the present invention in any form. It should be noted that those skilled in the art can make several modifications and improvements without departing from the concept of the present invention. These all belong to the protection scope of the present invention.
在本发明的描述中,需要理解的是,术语“上”、“下”、“前”、“后”、“左”、“右”、“竖直”、“水平”、“顶”、“底”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系,仅是为了便于描述本发明和简化描述,而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作,因此不能理解为对本发明的限制。In describing the present invention, it is to be understood that the terms "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", The orientation or positional relationship indicated by "bottom", "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying the referred device Or elements must have a certain orientation, be constructed and operate in a certain orientation, and thus should not be construed as limiting the invention.
如图1所示,实施例中,本发明提供的骶骨固定支架包含固定板1、支撑杆2、配接板5以及补片4。其中支撑杆2形成第一支撑杆21与第二支撑杆22,第一支撑杆21与第二支撑杆22呈一定夹角对称布置,支撑杆2主要由杆头部201、杆身部202、杆尾部203依次连接构成,固定板1安装在杆头部201,配接板5沿长度延伸方向的两端分别与第一支撑杆21的杆尾部203、第二支撑杆22的杆尾部203相连,第一支撑杆21、配接板5、第二支撑杆22依次平滑过渡连接,补片4则设置在第一支撑杆21与第二支撑杆22之间。如图2所示,固定板1上设置有多个钉孔11与多个截断槽12,钉孔11沿固定板1厚度方向贯穿固定板1,截断槽12沿固定板1宽度方向延伸,钉孔11、截断槽12在固定板1上沿长度延伸方向依次设置,钉孔11用于使用螺钉将固定板1固定在例如髂骨的组织结构上;截断槽12的作用是,便于根据在固定板1髂骨上的固定位置,将固定板1多余伸出的部分切割掉,防止对周边组织的割伤。优选地,所述钉孔11为花瓣形,花瓣形的钉孔11包含多个瓣体110,多个所述瓣体110沿钉孔11周向方向布置,如图8、图9所示,钉孔11包含三个瓣体110,在打入螺钉时,可以采用三根螺钉沿圆锥面分别打入到髂骨中,增加固定力度;当然所述钉孔11也可以是圆形的,保证在圆形的钉孔11能打入三根螺钉即可。进一步优选地,在一个钉孔11中打入的螺钉的数量还可以是两个、四个或更多个,根据实际需要调整,但相对来说,三个螺钉既保证了固定的稳定性,又保证了螺钉的打入操作不会过于困难。配接板5可根据患者术前骶骨CT所提示的数据进行弧度的设计,且具有一定柔性,以适应第一支撑杆21与第二支撑杆22之间夹角的变化。此外,在支撑杆2和/或配接板5上设置有穿线孔25,穿线孔25的孔口平滑延伸,穿线孔25用于穿设调长缝线,所述调长缝线一端连接补片4,另一端从穿线孔25中穿出,这样在手术过程中,可以根据需要拉紧或放松调长缝线,起到对补片4大小的调节作用,当补片4大小调节完毕后,将调长缝线打结固定即可,通过这一结构,可以使得补片4更好地起到托住盆腔器官的作用,防止术后病人因为咳嗽等剧烈活动导致器官疝出。优选地,所述补片4为网状结构,网状结构的构成丝线还可以是直接穿设在所述穿线孔25中。优选地,支撑杆2和/或配接板5的表面是是粗糙表面,进一步优选地,在粗糙表面上还加工有例如胶原蛋白膜的可吸收层,一方面减小手术后产生炎症的可能性,另一方面,方便了肌肉长入到支撑杆2与配接板5上,增加提高固定性能。优选地,在补片4的上表面上还加工有一层覆膜7,所述覆膜7为去细胞的真皮基质生物膜,在手术过程中起到防粘连的作用。As shown in FIG. 1 , in the embodiment, the sacral fixation bracket provided by the present invention includes a fixation plate 1 , a support rod 2 , an adapter plate 5 and a patch 4 . Wherein the support rod 2 forms the first support rod 21 and the second support rod 22, the first support rod 21 and the second support rod 22 are symmetrically arranged at a certain angle, and the support rod 2 is mainly composed of a rod head 201, a shaft portion 202, The rod tails 203 are sequentially connected to form, the fixing plate 1 is installed on the rod head 201, and the two ends of the adapter plate 5 along the length extension direction are respectively connected with the rod tails 203 of the first support rod 21 and the rod tails 203 of the second support rod 22 , the first support rod 21 , the adapter plate 5 , and the second support rod 22 are sequentially connected in a smooth transition, and the patch 4 is arranged between the first support rod 21 and the second support rod 22 . As shown in Figure 2, the fixed plate 1 is provided with a plurality of nail holes 11 and a plurality of cut-off grooves 12, the nail holes 11 penetrate the fixed plate 1 along the thickness direction of the fixed plate 1, and the cut-off grooves 12 extend along the width direction of the fixed plate 1. Holes 11 and cut-off grooves 12 are arranged successively along the length extension direction on the fixing plate 1, and the nail holes 11 are used to fix the fixing plate 1 on the tissue structure such as the ilium with screws; the effect of the cut-off groove 12 is to facilitate The fixed position on the ilium of the plate 1, cut off the redundant protruding part of the fixed plate 1, to prevent the cutting of the surrounding tissues. Preferably, the nail hole 11 is petal-shaped, and the petal-shaped nail hole 11 includes a plurality of petal bodies 110, and the plurality of petal bodies 110 are arranged along the circumferential direction of the nail hole 11, as shown in Fig. 8 and Fig. 9 , The nail hole 11 includes three petals 110. When screwing in, three screws can be used to drive into the iliac bone along the conical surface to increase the fixing strength; of course, the nail hole 11 can also be circular, ensuring Circular nail hole 11 can drive into three screws and get final product. Further preferably, the number of screws driven into one nail hole 11 can also be two, four or more, adjusted according to actual needs, but relatively speaking, three screws have not only ensured the stability of fixing, It is also ensured that the driving operation of the screw will not be too difficult. The adapter plate 5 can be designed in a radian according to the data suggested by the patient's preoperative sacrum CT, and has a certain degree of flexibility to adapt to changes in the angle between the first support rod 21 and the second support rod 22 . In addition, a threading hole 25 is provided on the support rod 2 and/or the adapter plate 5, and the opening of the threading hole 25 extends smoothly. sheet 4, and the other end passes through the threading hole 25, so that in the operation process, the suture can be tightened or loosened as required to adjust the size of the patch 4, and when the size of the patch 4 is adjusted , just tie the length-adjustable suture and fix it. Through this structure, the patch 4 can better support the pelvic organs and prevent postoperative patients from herniation of organs due to strenuous activities such as coughing. Preferably, the patch 4 is a mesh structure, and the wires constituting the mesh structure may also be directly threaded through the threading holes 25 . Preferably, the surface of the support rod 2 and/or the adapter plate 5 is a rough surface, and further preferably, an absorbable layer such as a collagen film is also processed on the rough surface, on the one hand reducing the possibility of postoperative inflammation On the other hand, it facilitates the growth of muscles into the support rod 2 and the adapter plate 5, increasing and improving the fixing performance. Preferably, a film 7 is processed on the upper surface of the patch 4, and the film 7 is a decellularized dermal matrix biofilm, which plays an anti-adhesion role during the operation.
优选例中,第一支撑杆21与第二支撑杆22之间也可以是相互平行的,根据实际使用情况进行调整,但相比之下,第一支撑杆21与第二支撑杆22之间设置夹角更符合仿骶骨的生物学特征。优选地,支撑杆2在长度延伸方向上存在弯曲,从侧面看,支撑杆2弯曲成符合人体生理曲线的形状,即骶尾骨的形状。优选地,第一支撑杆21与第二支撑杆22还可以是直接通过铰链连接的,支撑杆2在长度延伸方向上存在弯曲,以减少整体结构的高度,但是使用铰链会使得第一支撑杆21与第二支撑杆22之间的调节自由性有所减弱,整体结构的稳定性也会相应降低。优选例中,固定板1由柔性材料制成,在施加较大作用力的情况下,固定板1与长度延伸方向与宽度延伸方向上能够进行变形,以便于对髂骨表面的不规则形状进行适应贴合,但是固定板1的强度会相应降低;进一步优选地,在固定板1与髂骨进行贴合的一面上设置有钛网,进一步提高固定板1与髂骨的贴合度,另外,在固定板1上还可以贯穿设置注射孔,从注射孔中注射骨水泥或者生物活性材料,增加固定板1与髂骨的连接强度。优选地,截断槽12还可以是位于固定板1多个平面上。如图3所示,变化例中,固定板1包含多个板节261,相邻两个板节261之间通过万向调节杆262连接,板节261上设置钉孔11,用于打入螺钉,万向调节杆262则方便板节261之间进行转动,更好的适应髂骨的表面形状,当固定板1长度过长时,只需将万向调节杆262拗断即可。In a preferred example, the first support rod 21 and the second support rod 22 may also be parallel to each other, and adjustments shall be made according to actual usage conditions, but in comparison, the distance between the first support rod 21 and the second support rod 22 Setting the included angle is more in line with the biological characteristics of the imitation sacrum. Preferably, the support rod 2 is bent in the direction of its length extension. Viewed from the side, the support rod 2 is bent into a shape conforming to the physiological curve of the human body, that is, the shape of the sacrum. Preferably, the first support rod 21 and the second support rod 22 can also be directly connected by a hinge, and the support rod 2 is bent in the direction of length extension to reduce the height of the overall structure, but the use of a hinge will make the first support rod The adjustment freedom between 21 and the second support rod 22 is weakened, and the stability of the overall structure will be correspondingly reduced. In a preferred example, the fixing plate 1 is made of a flexible material. When a large force is applied, the fixing plate 1 can be deformed in the direction of length extension and the direction of width extension, so as to adjust the irregular shape of the surface of the ilium. It is suitable for fitting, but the strength of the fixed plate 1 will be correspondingly reduced; further preferably, a titanium mesh is arranged on the side where the fixed plate 1 and the ilium are fitted, so as to further improve the fit between the fixed plate 1 and the ilium, and in addition Injection holes can also be provided through the fixing plate 1, and bone cement or bioactive materials can be injected through the injection holes to increase the connection strength between the fixing plate 1 and the ilium. Preferably, the cut-off groove 12 can also be located on multiple planes of the fixing plate 1 . As shown in Figure 3, in the modification example, the fixed plate 1 includes a plurality of plate sections 261, and two adjacent plate sections 261 are connected by a universal adjustment rod 262, and nail holes 11 are provided on the plate sections 261 for driving in The screw and the universal adjusting rod 262 facilitate the rotation between the plate segments 261 to better adapt to the surface shape of the ilium. When the length of the fixing plate 1 is too long, it is only necessary to break the universal adjusting rod 262.
如图4所示,在杆头部201、杆身部202或杆尾部203上还设置有伸缩杆6,可以在手术中根据神经血管等组织的位置,对穿线孔25的位置进行相应的调节。如图5至图7所示,伸缩杆包含位移件61与翻转块62,多个位移件61中包含第一位移件611与第二位移件612,第一位移件611与第二位移件612中心对称布置,多个翻转块62设置在第一位移件611与第二位移件612之间,多个所述翻转块62之间通过翻转弹性绳连接。第一位移件611与第二位移件612之间也设置有弹性件,弹性件保持将第一位移件611与第二位移件612拉靠近的趋势,实施例中,所述弹性件包含拉合弹性绳631,拉合弹性绳631贯穿其中一个翻转块62设置,或者被该翻转块62分隔成两段。如图5至图7所示,第一位移件611与第二位移件612相对的两个面为台阶面,沿第一位移件611的厚侧端6150向薄侧端6160方向,台阶面水平部分依次形成第一贴压面61031、第二贴压面61032、第三贴压面61033、第四贴压面61034这四个贴压面,台阶面竖直部分依次形成第一阻回面61021、第二阻回面61022、第三阻回面61023这三个阻回面;位移件61的厚侧端6150的端面形成拉引面6101,拉引面6101用于与支撑杆2相连。翻转块62横截面形状为长方形,长方形横截面的长度、宽度不等;翻转块62的长度方向延伸面形成长位面6201,翻转块62的宽度方向延伸面形成宽位面6202。定义宽位面6202与贴压面平行时,翻转块62处于站立状态;长位面6201与贴压面平行时,翻转块62处于倒下状态。多个翻转块62中包含第一翻转块621、第二翻转块622、第三翻转块623、第四翻转块624这四种规格的翻转块62,沿翻转块62排布路径的中心到两端的方向上,第一翻转块621、第二翻转块622、第三翻转块623、第四翻转块624依次布置,拉合弹性绳631连接在第一翻转块621上。第一翻转块621、第二翻转块622、第三翻转块623、第四翻转块624之间依次通过第一翻转弹性绳6321、第二翻转弹性绳6322、第三翻转弹性绳6323连接,第四翻转块624的外侧还连接有拉引绳633,拉引绳633用于与支撑杆2相连,位于同一侧的拉引面6101与拉引绳633同时连接在支撑杆2的同一端。实施例中,第一翻转弹性绳6321、第二翻转弹性绳6322、第三翻转弹性绳6323的弹性系数依次降低,此外,翻转弹性绳连接在翻转块的长位面6201上,但并非连接长位面6201的几何中心,而是在翻转块62均处于站立状态时沿上下方向交错分布,这样方便在拉动拉引绳633时,实现由两端到中心的翻转块62依次翻转。优选地,在一个翻转块62的两个宽位面6202中,其中的一个宽位面6202通过一根翻转弹性绳连接至沿翻转块62排布路径方向上相邻的另一个翻转块62的宽位面6202,其中的另一个宽位面6202通过另一根翻转弹性绳连接至沿翻转块62排布路径方向上相邻的又一个翻转块62的宽位面6202,或者,其中的另一个宽位面6202通过拉引绳633连接至杆头部201、杆身部202或杆尾部203的刚性杆部。As shown in Figure 4, a telescopic rod 6 is also provided on the rod head 201, the shaft 202 or the rod tail 203, so that the position of the threading hole 25 can be adjusted accordingly during the operation according to the position of tissues such as nerves and blood vessels. . As shown in Figures 5 to 7, the telescopic rod includes a displacement member 61 and a turning block 62, and the plurality of displacement members 61 includes a first displacement member 611 and a second displacement member 612, and the first displacement member 611 and the second displacement member 612 The center is symmetrically arranged, and a plurality of turning blocks 62 are arranged between the first displacement member 611 and the second displacement member 612 , and the plurality of turning blocks 62 are connected by turning elastic ropes. An elastic member is also arranged between the first displacement member 611 and the second displacement member 612, and the elastic member maintains a tendency to draw the first displacement member 611 and the second displacement member 612 closer together. In the embodiment, the elastic member includes pulling The elastic rope 631 is pulled and closed. The elastic rope 631 is arranged through one of the turning blocks 62 , or is separated into two sections by the turning block 62 . As shown in Figures 5 to 7, the two opposite surfaces of the first displacement member 611 and the second displacement member 612 are stepped surfaces, along the direction from the thick side end 6150 to the thin side end 6160 of the first displacement member 611, the step surface is horizontal The first pressing surface 61031, the second pressing surface 61032, the third pressing surface 61033, and the fourth pressing surface 61034 are sequentially formed on the part, and the vertical part of the step surface forms the first resistance surface 61021 in turn. , the second resistance surface 61022 , and the third resistance surface 61023 ; The cross-sectional shape of the overturning block 62 is rectangular, and the length and width of the rectangular cross-section are not equal; It is defined that when the wide plane 6202 is parallel to the pressing surface, the overturning block 62 is in a standing state; when the long plane 6201 is parallel to the pressing plane, the overturning block 62 is in a fallen state. A plurality of turning blocks 62 include turning blocks 62 of four specifications, the first turning block 621, the second turning block 622, the third turning block 623, and the fourth turning block 624, along the center of the turning block 62 arrangement path to two In the direction of the end, the first overturning block 621 , the second overturning piece 622 , the third overturning piece 623 , and the fourth overturning piece 624 are arranged in sequence, and the pulling elastic rope 631 is connected to the first overturning piece 621 . The first overturning block 621, the second overturning piece 622, the third overturning piece 623, and the fourth overturning piece 624 are connected by the first overturning elastic cord 6321, the second overturning elastic cord 6322, and the third overturning elastic cord 6323 in turn. Pulling ropes 633 are also connected to the outer sides of the four overturning blocks 624. The pulling ropes 633 are used to connect with the support rod 2, and the pulling surface 6101 on the same side is connected to the same end of the support rod 2 as the pulling rope 633. In the embodiment, the elastic coefficients of the first overturning elastic cord 6321, the second overturning elastic cord 6322, and the third overturning elastic cord 6323 decrease successively. In addition, the overturning elastic cord is connected to the long plane 6201 of the overturning block, but is not connected to the long plane. The geometric center of the plane 6201 is staggered in the vertical direction when the overturning blocks 62 are in a standing state, so that when the pulling rope 633 is pulled, the overturning blocks 62 from both ends to the center are turned over in turn. Preferably, among the two wide planes 6202 of an overturning block 62, one of the wide planes 6202 is connected to the other adjacent overturning block 62 in the direction along the path of the overturning block 62 through an overturning elastic cord. The wide surface 6202, the other wide surface 6202 of which is connected to the wide surface 6202 of another inverting block 62 adjacent to the direction of the arrangement path of the inverting block 62 through another inverting elastic rope, or the other in which A wide surface 6202 is connected to the rigid shaft portion of the head portion 201 , the shaft portion 202 or the butt portion 203 via a pull cord 633 .
伸缩杆6的工作原理为:初始状态下,伸缩杆6结构如图5所示,翻转块62均处于站立状态,在翻转弹性绳的作用下,翻转块62依次排布在第一贴压面61031上,拉合弹性绳631处于拉伸状态,并且在回弹力的作用下,第一贴压面61031与第四翻转块624的宽位面6202贴合,此时两个位移件61的拉引面6102之间距离最短;拉动拉引面6101与拉引绳633,第四翻转块624发生旋转,并从站立状态变为倒下状态,翻转块62的最大高度降低,在拉合弹性绳631回弹力作用下,两个位移件61之间相互靠拢,如图6所示,此时若停止拉动拉引面6101与拉引绳633,第四翻转块624的一个宽位面6202与第一阻回面61021接触,阻止了第一翻转块621在第三翻转弹性绳6323的作用下恢复至站立状态,第一位移件611与第二位移件612在第四翻转块624和/或第三翻转块623的支撑,以及拉合弹性绳631的拉引作用下,保持高度方向的稳定;继续拉动拉引面6101与拉引绳633,第三翻转块623、第二翻转块622、第一翻转块621将依次发生翻转,两个位移件61的拉引面6102之间距离逐渐变大,如图7所示,此时,第四翻转块624、第三翻转块623、第二翻转块622分别与第三阻回面61023、第二阻回面61022、第一阻回面61021结构,两个位移件61受到四种翻转块62中的任一种或任多种翻转块62的支撑,以及拉合弹性绳631的拉引作用,最终保持伸缩杆6整体的稳定性。当需要缩短两个位移件61的拉引面6102之间距离时,只需将两块位移件61相互拉开远离即可。The working principle of the telescopic rod 6 is as follows: in the initial state, the structure of the telescopic rod 6 is shown in Figure 5, and the flipping blocks 62 are all in a standing state. Under the action of the flipping elastic rope, the flipping blocks 62 are arranged on the first pressing surface 61031, the pulling elastic rope 631 is in a stretched state, and under the action of the resilience force, the first pressing surface 61031 is attached to the wide surface 6202 of the fourth turning block 624. At this time, the pulling force of the two displacement parts 61 The distance between the guide surfaces 6102 is the shortest; when the pull guide surface 6101 and the pull rope 633 are pulled, the fourth flipping block 624 rotates and changes from a standing state to a fallen state, and the maximum height of the flipping block 62 decreases. Under the action of the resilience force of 631, the two displacement parts 61 move closer to each other, as shown in Figure 6, if the pulling of the pulling surface 6101 and the pulling rope 633 is stopped at this time, a wide surface 6202 of the fourth turning block 624 and the first A return preventing surface 61021 is in contact with, preventing the first turning block 621 from returning to the standing state under the action of the third turning elastic cord 6323, and the first displacement member 611 and the second displacement member 612 are in the fourth turning block 624 and/or the first turning member 624. Under the support of the three overturning blocks 623 and the pulling action of the pulling elastic rope 631, the stability in the height direction is maintained; continue to pull the pulling surface 6101 and the pulling rope 633, the third overturning piece 623, the second overturning piece 622, the third overturning piece 622, and the third overturning piece 623 One turning block 621 will turn over in turn, and the distance between the pulling surfaces 6102 of the two displacement parts 61 becomes larger gradually, as shown in Figure 7, at this moment, the fourth turning block 624, the third turning block 623, the second turning block The block 622 is respectively connected with the third anti-return surface 61023, the second anti-return surface 61022, and the first anti-return surface 61021. The two displacement members 61 are subjected to any one or any kind of overturning blocks 62 in the four kinds of overturning blocks 62. The support, as well as the pulling effect of pulling the elastic rope 631 , ultimately maintain the overall stability of the telescopic rod 6 . When the distance between the pulling surfaces 6102 of the two displacement elements 61 needs to be shortened, it is only necessary to pull the two displacement elements 61 away from each other.
优选例中,翻转块62的规格种类并不限于上述的四种,可以根据需求的调节长度进行调整,翻转块62的数量也相应的改变,但需保证沿翻转块62排列方向按从中间位置到两端位置延伸时,多个翻转块62之间尺寸规格从小到大变化,具体地,当翻转块62都处于站立状态时,从中间位置到两端位置方向上,多个翻转块62之间的高度从小到大变化;相应地,多根翻转弹性绳之间弹性从大到小变化,相邻两根翻转弹性绳存在上下方向位置高度的变化;进一步优选地,翻转块62在左右方向上还可以是不对称的,但是在使用时会出现调节不够平滑连贯的现象。优选地,翻转块62与阻回面还可以并不是一一对应的关系,也就是说,在拉动伸缩杆6的过程中,存在翻转块62处于倒下状态时并没有与阻回面直接接触,而是通过相邻的一个翻转块62与阻回面接触,以减少位移件61的加工难度,但这种结构存在轴向固定不够稳定的缺点。优选地,翻转弹性绳的弹性还可以是一致的,安装位置也可以是在翻转块62的几何中心位置,装配更加容易,但是会导致翻转块62的翻转变得混乱。In the preferred example, the specifications and types of the flipping blocks 62 are not limited to the above four types, and can be adjusted according to the adjustment length required, and the quantity of the flipping blocks 62 is also changed accordingly, but it is necessary to ensure that the alignment direction of the flipping blocks 62 is from the middle position. When the two ends are extended, the sizes and specifications of the plurality of overturning blocks 62 vary from small to large. Specifically, when the overturning blocks 62 are all in a standing state, from the middle position to the two ends, the number of overturning blocks 62 The height between them changes from small to large; correspondingly, the elasticity between the multiple turning elastic ropes changes from large to small, and there is a change in the position height of two adjacent turning elastic ropes in the up and down direction; further preferably, the turning block 62 is in the left and right direction It can also be asymmetrical, but the adjustment will not be smooth and coherent when used. Preferably, there may not be a one-to-one correspondence between the overturning block 62 and the anti-return surface, that is to say, during the process of pulling the telescopic rod 6, the overturning block 62 does not directly contact the anti-return surface when it is in a fallen state. , but through an adjacent overturning block 62 in contact with the anti-return surface to reduce the processing difficulty of the displacement member 61, but this structure has the disadvantage that the axial fixation is not stable enough. Preferably, the elasticity of the overturning elastic rope can also be consistent, and the installation position can also be at the geometric center of the overturning block 62 , which is easier to assemble, but it will cause confusion about the overturning of the overturning block 62 .
优选地,位移件61上还可以设置通孔,用于插入紧固件将第一位移件611与第二位移件612进行固定,进一步限制调节到位的伸缩杆6的运动。优选地,在伸缩杆6外还设置有套筒64,套筒64套接在伸缩杆6上,伸缩杆6全部位于套筒64内部;套筒64的侧壁面为光滑面。套筒64沿竖截面分为两瓣,通过卡扣或紧固件连接后将伸缩杆6包裹在内,防止伸缩杆6上的尖锐部分对周边组织造成伤害。Preferably, a through hole may also be provided on the displacement member 61 for inserting fasteners to fix the first displacement member 611 and the second displacement member 612 , so as to further limit the movement of the adjusted telescopic rod 6 . Preferably, a sleeve 64 is provided outside the telescopic rod 6 , the sleeve 64 is sleeved on the telescopic rod 6 , and all the telescopic rods 6 are located inside the sleeve 64 ; the side wall surface of the sleeve 64 is a smooth surface. The sleeve 64 is divided into two parts along the vertical section, and wraps the telescopic rod 6 after being connected by snaps or fasteners, so as to prevent the sharp parts on the telescopic rod 6 from causing damage to surrounding tissues.
以上对本发明的具体实施例进行了描述。需要理解的是,本发明并不局限于上述特定实施方式,本领域技术人员可以在权利要求的范围内做出各种变形或修改,这并不影响本发明的实质内容。在不冲突的情况下,本申请的实施例和实施例中的特征可以任意相互组合。Specific embodiments of the present invention have been described above. It should be understood that the present invention is not limited to the specific embodiments described above, and those skilled in the art may make various changes or modifications within the scope of the claims, which do not affect the essence of the present invention. In the case of no conflict, the embodiments of the present application and the features in the embodiments can be combined with each other arbitrarily.
Claims (10)
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